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Sweet L, Hughes J, Rasheed A, Vasilevski V. An innovative low-cost breast pump-hire program to enhance breastfeeding rates in a neonatal intensive care unit. J Adv Nurs 2024. [PMID: 38558479 DOI: 10.1111/jan.16180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/13/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
AIM To evaluate the outcomes of a low-cost hospital-grade breast pump hire program for women experiencing financial hardship with infants in neonatal intensive care. DESIGN A multi-method evaluation including data audits and surveys. METHODS Twenty-four electric breast pumps were purchased and rented to mothers at a cost of $1/day. To be eligible, mothers needed to have given birth to an infant <32 weeks and/or <1500 g and self-identified as experiencing financial hardship. Data were collected by (1) a retrospective audit to evaluate infant feeding and clinical outcomes at hospital discharge; (2) prospective telephone surveys to evaluate women's satisfaction with the program; and (3) analysis of the breast pump register to determine any loss or damages. RESULTS Twenty-four mothers of 26 infants participated in the program. More than half of the infants were exclusively breastmilk fed at hospital discharge, and more than three-quarters were fed a combination of breastmilk and formula. Women who intended to formula feed were supported to provide breastmilk to their infants in the first few weeks of life. Most participants were highly satisfied with the program. Women reported that accessibility to a hospital-grade breast pump improved their ability to provide expressed breastmilk to their infants. Most participants were 'extremely satisfied' with the performance of the breast pump. One-quarter of the women reported that they would have exclusively formula-fed if they did not have access to the breast pump hire program. The audit of the equipment register showed no reported technical issues, loss or damages. CONCLUSION The findings suggested that the low-cost breast pump hire program supported equitable care, increasing women's ability to provide expressed breastmilk for their infants. IMPACT Providing access to low-cost hospital-grade breast pumps to mothers of vulnerable infants is likely to prevent poor infant clinical outcomes and improve women's care satisfaction. PUBLIC OR PATIENT CONTRIBUTION Nil.
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Affiliation(s)
- Linda Sweet
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research, Western Health Partnership, Institute for Health Transformation, St Albans, Victoria, Australia
| | - Jessica Hughes
- Tweddle Child and Family Health Service, Wyndam, Victoria, Australia
| | | | - Vidanka Vasilevski
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research, Western Health Partnership, Institute for Health Transformation, St Albans, Victoria, Australia
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Walsh A, McCluskey R, Cassidy D, McGoldrick G, Howlin C, Muldoon K, Butler É, Byrne G. The Support Needs and Current Practices of Public Health Nurses in the Republic of Ireland Who Provide Support to Breastfeeding Mothers: A Cross-Sectional Survey. J Hum Lact 2023; 39:733-742. [PMID: 37232139 PMCID: PMC10580677 DOI: 10.1177/08903344231172991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 04/13/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Breastfeeding continuation rates are low in Ireland. The Breastfeeding Observation and Assessment Tool (BOAT) was developed to assist public health nurses in assessing breastfeeding challenges; however, little is known of its actual usage, the level of training experienced or desired by public health nurses, or their level of confidence in the support they provide to breastfeeding mothers. RESEARCH AIM To identify the current practices and support needs of public health nurses who provide breastfeeding support in Ireland. METHOD An online questionnaire was devised to collect respondents' confidence with breastfeeding issues, caseload, and practices. It was distributed to public health nurses with a current child health caseload in one Community Healthcare Organization. Mann Whitney U tests were used to ascertain the relationship between public health nurses' confidence level and those with qualifications in midwifery or as an International Board Certified Lactation Consultant (IBCLC). RESULTS The survey was completed by 66 public health nurses. Only 14 respondents (21.2%) indicated that they always used the BOAT. The most common reason for not doing so was a lack of education on its use (n = 17, 25.8%). Postholders also certified as IBCLCs were considered by participants to be the most appropriate professionals to resolve certain breastfeeding issues. Confidence levels to manage breastfeeding issues were highest among public health nurses with IBCLC credentialing (U = 12.5, p = .001) while no difference was seen when comparing those with a midwifery degree to those without (U = 184.0, p = .92). Face-to-face workshops and blended-learning approaches were ranked as the preferred formats for breastfeeding education (Median rank = 2). CONCLUSIONS Breastfeeding education incorporating a face-to-face component is needed to support public health nurses who work with breastfeeding mothers, as is prioritization of recruitment in the community of public health nurses with IBCLC credentials.
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Affiliation(s)
- Annemarie Walsh
- Dublin South, Kildare and West Wicklow Community Healthcare Organisation 7 (CHO 7), Health Service Executive, Dublin, Ireland
| | - Rachel McCluskey
- Dublin South, Kildare and West Wicklow Community Healthcare Organisation 7 (CHO 7), Health Service Executive, Dublin, Ireland
| | - Deirdre Cassidy
- Dublin South, Kildare and West Wicklow Community Healthcare Organisation 7 (CHO 7), Health Service Executive, Dublin, Ireland
| | - Gerardine McGoldrick
- Dublin South, Kildare and West Wicklow Community Healthcare Organisation 7 (CHO 7), Health Service Executive, Dublin, Ireland
| | - Claire Howlin
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Kathryn Muldoon
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Éadaoin Butler
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Gobnait Byrne
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Buckland C, Hector D, Kolt GS, Thepsourinthone J, Arora A. Experiences of young Australian mothers with infant feeding. BMC Pregnancy Childbirth 2022; 22:489. [PMID: 35705921 PMCID: PMC9199343 DOI: 10.1186/s12884-022-04796-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the overwhelming evidence of health and other benefits of breastfeeding and recommendations to breastfeed by peak health bodies, breastfeeding rates are significantly lower than recommended in Australia and globally. Young mothers are identified as being at high risk of not breastfeeding their infants according to infant feeding recommendations. This study aimed to gain an in-depth understanding of young Australian mothers' experiences of infant feeding, and to explore the factors which facilitated or hindered adherence to recommended breastfeeding practices. METHODS Purposive and snowball sampling were used to recruit young mothers in Australia (n = 17) aged 18-25 years who had given birth to their first child within the last two years. Data were collected through semi-structured interviews via online videoconferencing. Interviews were audio-recorded, transcribed verbatim, coded, and subsequently analysed. Thematic analysis was conducted using Quirkos, a qualitative data management and analysis software. RESULTS Four major themes were identified: Breastfeeding is challenging; Feeling judged about infant feeding choices; Experiences with breastfeeding support; and Experiences and views on breastfeeding education. Most mothers reported experiencing breastfeeding challenges, particularly those arising from lactation difficulties, yet many were able to overcome these challenges through their determination to breastfeed. Many mothers expressed perceiving judgement from others for breastfeeding in public. Some mothers who were bottle feeding their infants, whether with expressed breast milk or infant formula, felt that they were being judged for using a bottle. Many mothers reported professional, partner, family, and peer support as critical facilitators to the continuation of breastfeeding. Most mothers shared positive experiences of attending breastfeeding education sessions, but indicated the need for community education to reduce judgement toward mothers' infant feeding decisions. CONCLUSIONS The barriers and enablers to infant feeding experienced by young mothers are similar to those experienced by mothers of all ages. Young mothers experience significant breastfeeding challenges and need support from partner, family, peers, and professionals to continue breastfeeding in line with recommendations. Breastfeeding campaigns to support young mothers should be aimed at the wider community to increase awareness of breastfeeding challenges, reduce stigma associated with breastfeeding in public, and to support mothers in their infant feeding decisions.
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Affiliation(s)
- Christa Buckland
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.
| | - Debra Hector
- Cancer Australia, Surry Hills, NSW, 2010, Australia
| | - Gregory S Kolt
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Jack Thepsourinthone
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia
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Bigalky J, Dietrich Leurer M, McCabe J, Mackey A, Laczko D, Deobald V. Advice from Canadian Mothers Who Express Human Milk: An Interpretive Description Qualitative Study. Matern Child Health J 2021; 26:342-350. [PMID: 34609705 DOI: 10.1007/s10995-021-03237-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Human milk expression has become an increasingly common means for providing milk to an infant, with women expressing to address breastfeeding problems or to allow for flexible feeding options. This study explored the experiences and recommendations of mothers who expressed human milk, with this paper reporting on the advice mothers would offer to other mothers to address common challenges. METHODS Interpretive description was used in this qualitative project. Using purposive sampling, mothers of infants aged 0-24 months who expressed human milk were recruited to participate from two health regions in western Canada. Individual, audio-taped interviews were completed with 35 women. NVIVO™ software was used for data analysis. RESULTS Mothers reported the desire to offer experiential advice to other mothers navigating milk expression and encouraged other mothers to seek guidance from health care professionals such as lactation consultants, peer support online, and from family and friends. Experiential knowledge shared included: (a) product recommendations, (b) expression tips, (c) support for workplace expression, (d) encouragement to seek help, and (e) moral support. CONCLUSIONS Healthcare professionals should include evidence-based expression information as part of routine lactation support, while recognizing the importance of mother-to-mother knowledge transfer and emotional support. Services that assist mothers to determine and access pumps appropriate to their unique breastfeeding needs and goals should be offered, and the opportunity for peer support through creation of, or referral to, appropriate in-person or online support groups should be made available.
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Affiliation(s)
- Jodie Bigalky
- College of Nursing, University of Saskatchewan, Regina Campus, #100 4400-4th Avenue, Regina, SK, S4T 0H8, Canada.
| | - Marie Dietrich Leurer
- College of Nursing, University of Saskatchewan, Regina Campus, #100 4400-4th Avenue, Regina, SK, S4T 0H8, Canada
| | - Janet McCabe
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - April Mackey
- College of Nursing, University of Saskatchewan, Regina Campus, #100 4400-4th Avenue, Regina, SK, S4T 0H8, Canada
| | | | - Virginia Deobald
- College of Nursing, University of Saskatchewan, Regina Campus, #100 4400-4th Avenue, Regina, SK, S4T 0H8, Canada
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McInnes RJ, Gillespie N, Crossland N, Hall Moran V, Hoddinott P. Women's views about a free breast pump service: Online survey informing intervention development. MATERNAL & CHILD NUTRITION 2019; 15:e12745. [PMID: 30381867 PMCID: PMC7198920 DOI: 10.1111/mcn.12745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 10/10/2018] [Accepted: 10/16/2018] [Indexed: 11/30/2022]
Abstract
Improving breastfeeding outcomes is a global priority; however, in the United Kingdom, continuation of breastfeeding remains low. Growing empirical evidence suggests a free breast pump service might be an acceptable and feasible incentive intervention to improve breastfeeding outcomes and reduce heath inequalities. To inform intervention development, we conducted an online survey with women recruited via social media using snowball sampling. Data were analysed descriptively (closed questions) with qualitative thematic analysis (free text). The survey was completed by 666 women, most of whom had recently breastfed and used a breast pump. Participants agreed that free pump hire (rental/loan; 567 women; 85.1%) or a free pump to keep (408; 61.3%) should be provided. Free text comments provided by 408 women (free pump) and 309 women (free hire) highlighted potential benefits: helping women to continue breastfeeding; express milk; overcome difficulties; and pump choice. Concerns are possible effect on breast milk supply, reduced breastfeeding, pumps replacing good support for breastfeeding, and pump hire hygiene. Personal and societal costs are important issues. Some suggested a pump service should be for low-income mothers, those with feeding difficulties or sick/preterm infants. A one-size service would not suit all and vouchers were proposed. Some suggested fees and deposits to prevent waste. To our knowledge, this is the first study reporting views about the acceptability of providing a free breast pump hire service. Mothers support and wish to have a say in breast pump service development. Future evaluations should address impact on feeding outcomes, professional support, hygiene for hired pumps, and costs.
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Affiliation(s)
- Rhona J. McInnes
- Associate Professor in Maternal Health & Consultant Midwife for NHS Lothian, School of Health and Social CareEdinburgh Napier University (ENU)EdinburghScotland
| | - Nicola Gillespie
- Research Midwife, Nursing Midwifery Allied Health Professions Research UnitGlasgow Caledonian UniversityGlasgowScotland
| | - Nicola Crossland
- Research Associate, Maternal and Infant Nutrition and Nurture Unit, College of Health and WellbeingUniversity of Central LancashirePrestonUK
| | - Victoria Hall Moran
- Associate Professor, Maternal and Infant Nutrition and Nurture Unit, College of Health and WellbeingUniversity of Central LancashirePrestonUK
| | - Pat Hoddinott
- Chair in Primary Care, Nursing Midwifery and Allied Health Professions Research UnitUniversity of StirlingStirlingUK
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